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Contractor License Application

  1. Contact Information

  2. Business Information

  3. No license shall become effective until such date as the required certificate of insurance has been submitted and is on file with the Village.

  4. By submitting this form, you agree and acknowledge that 1) your application will not be "Signed" in the sense of a traditional paper document and 2) by signing in this alternate manner, you agree that your “electronic signature” is valid and binding upon you to the same force and effect as a handwritten signature.

  5. For Village Use Only

  6. License No:

  7. Expiration Date:

  8. Date Issued:

  9. Fee Received:

  10. Approved By:

  11. Leave This Blank:

  12. This field is not part of the form submission.